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Trajectories of antidepressant drugs during pregnancy: A cohort study from a community‐based sample
Author(s) -
Cabaillot Aurélie,
Bourset Alexandra,
Mulliez Aurélien,
Delorme Jessica,
Orri Massimiliano,
VicardOlagne Mathilde,
Zenut Marie Christine,
Tournier Marie,
Gallot Denis,
Authier Nicolas,
Chenaf Chouki,
Laporte Catherine
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14449
Subject(s) - pregnancy , medicine , antidepressant , childbirth , cohort , obstetrics , medical prescription , postpartum period , cohort study , psychiatry , pediatrics , anxiety , genetics , pharmacology , biology
Aims The aim of this study was to monitor the trajectories of antidepressant use during pregnancy and the postpartum period among women chronically treated with antidepressants before their pregnancy, and to assess characteristics associated with each trajectory. Methods This cohort study included all pregnant women whose data were included in the General Sample of Beneficiaries (EGB) database affiliated with the French Health Insurance System, from 2009 to 2014. Women were followed up until 6 months after childbirth. Chronic treatment was defined as exposure over the 6‐month period preceding pregnancy. A group‐based trajectory model (GBMT) was estimated to identify distinctive longitudinal profiles of antidepressant use. Results Among 760 women chronically treated with antidepressants before their pregnancy, 55.8% stopped their treatment permanently in the first trimester, 20.4% discontinued it for a minimum of 3 months and resumed it postpartum, and 23.8% maintained it throughout pregnancy and postpartum. No sociodemographic or medical characteristics were associated with any trajectory group. Women who maintained treatment presented more frequent obstetric complications and postpartum psychiatric disorders. Among women who interrupted treatment, prescription of benzodiazepines and anxiolytics decreased initially but rose postpartum to a higher level than before pregnancy. Conclusions Pregnant women treated with antidepressant require a re‐evaluation of psychiatric treatment. It is necessary to pay attention to obstetric complications for severely depressed women. Additionally, as relapse was associated with increased benzodiazepine use, it is important to carefully monitor all women who stop antidepressant treatment during pregnancy.